Section 3. The by-laws of a medical service corporation may contain any lawful provisions approved by the commissioner, and shall provide that a majority of the incorporators or members of the corporation and a majority of the directors shall at all times be persons who are not providers of health services licensed under the laws of the commonwealth and that a majority of the directors shall at all times be persons who are or agree to become subscribers to the nonprofit medical service plan. The by-laws of such a corporation may define the qualifications of those persons eligible to become subscribers as provided in section five. Any such corporation may adopt such rules and regulations as may be consistent with the provisions of this chapter. Such rules and regulations and any changes or amendments thereto shall be filed with the commissioner thirty days before their effective dates and shall be subject to subsequent disapproval by the commissioner.
Any medical service corporation may contract with a corporation formed under chapter one hundred and seventy-six A for the joint or co-operative administration of their affairs and for the joint or co-operative writing and issuing of subscription certificates, and shall contract with a corporation formed under chapter one hundred and seventy-six A for the joint or cooperative administration of their affairs when acting as a carrier under chapter one hundred and seventy-six G.
Any medical service corporation may join with any other medical service corporation organized either under the laws of the commonwealth or of any other state for the purpose of establishing or maintaining an agency or corporation designed to facilitate the provision of medical service for residents of the commonwealth employed by firms having employees located in more than one state and may enter into contracts with such an agency or corporation or with a corporation owned by such an agency or corporation for the joint administration of their business and for the joint and cooperative writing and issuing of certificates, provided that any corporation or agency which is not a nonprofit medical service corporation with which there is joint and cooperative writing and issuing of certificates shall be qualified to do business in the commonwealth.
Any medical service corporation may contract with any agency of the United States of America, of the commonwealth or of any city or town within the commonwealth or with any corporation organized under general or special laws for any of the purposes mentioned in chapter one hundred and eighty for the purpose of providing medical service or other health services or reimbursement for such medical service or other health services.
Any medical service corporation which contracts with any agency of the United States of America to provide benefits under Title XVIII of the Social Security Act shall require that a practitioner who participates in said program shall post, in a conspicuous place, his policy regarding the acceptance of medicare assignment, and also require that said practitioner shall inform all eligible persons of his policy regarding medicare assignment prior to the delivery of care and services.
Other provisions of this chapter and chapter one hundred and seventy-six G notwithstanding, any medical service corporation, either individually or by contract with a corporation formed under chapter one hundred and seventy-six A, one or more hospitals licensed under chapter one hundred and eleven, one or more health maintenance organizations under chapter one hundred and seventy-six G, physicians registered under chapter one hundred and twelve and other providers of health care licensed or registered pursuant to chapter one hundred and eleven and chapter one hundred and twelve or one or more insurance companies licensed under chapter one hundred and seventy-five, may establish, maintain, operate, own or offer plans, programs or arrangements which have been approved by the commissioner under said chapter one hundred and seventy-six I.
A medical service corporation shall not condition its willingness to allow any physician or other provider of health services to participate in a preferred provider arrangement on such physician's or provider's agreeing to enter into other contracts or arrangements with the medical service corporation or any other persons that are not part of or related to such preferred provider arrangement.
The terms and conditions offered by a medical service corporation that must be met or agreed to by physicians and other providers of health services desiring to enter into a preferred provider arrangement or plan shall be fair and reasonable. No physician or other provider of health services willing to meet the reasonable terms and conditions proposed or offered in connection with such preferred arrangements shall be denied the opportunity to offer to enter into an agreement with such medical service corporation. The terms and conditions offered by a medical service corporation that must be met or agreed to by physicians and other providers of health services desiring to enter into such agreements shall be subject to the disapproval of the commissioner.
Structure Massachusetts General Laws
Part I - Administration of the Government
Chapter 176b - Medical Service Corporations
Section 2 - Incorporators; Formation; Articles of Organization; Certification
Section 3 - By-Laws; Joint Service Contracts; Preferred Provider Arrangements
Section 3a - Contracts of Reinsurance
Section 3b - Group Medical Service Agreements; Contribution Percentages
Section 4d - Refusal to Contract With Blind or Deaf Persons; Prohibition
Section 4e - Diethylstilbestrol Exposure; Discrimination
Section 4f - Cardiac Rehabilitation Expense Benefits
Section 4g - Certified Nurse Midwife Services Benefits
Section 4h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care
Section 4i - Cytologic Screening and Mammographic Examination Benefits
Section 4j - Infertility Diagnosis and Treatment Benefits
Section 4k - Nonprescription Enteral Formulas for Home Use
Section 4l - Chiropractic Services Benefits
Section 4m - Standardized Claim Form
Section 4n - Off-Label Drug Use; Cancer
Section 4o - Medical Service Agreement Coverage for Bone Marrow Transplants
Section 4p - Off-Label Use of Prescription Drugs for HIV/AIDS Treatment
Section 4q - Coverage for Licensed Hospice Services
Section 4r - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment
Section 4s - Items Medically Necessary for Diagnosis and Treatment of Diabetes
Section 4u - Emergency Services Provided to Insureds for Emergency Medical Conditions
Section 4v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing
Section 4x - Coverage for Patient Care Services Provided Under Qualified Clinical Trials
Section 4y - Coverage for Speech, Hearing and Language Disorders
Section 4aa - Coverage for Prosthetic Devices and Repairs
Section 4bb - Coverage for Eligible Dependents Under 26 Years of Age
Section 4cc - Coverage for Medically Necessary Hypodermic Syringes or Needles
Section 4dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder
Section 4ee - Coverage for Children 21 Years of Age or Younger for Hearing AIDS and Related Services
Section 4ff - Coverage for Orally Administered Anticancer Medications
Section 4gg - Coverage for Abuse Deterrent Opioid Drug Products
Section 4hh - Preauthorization for Substance Abuse Treatment Not to Be Required
Section 4ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services
Section 4jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease
Section 4mm - Pain Management Access Plans
Section 4nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products
Section 4pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs
Section 4qq - Coverage for Prescription Eye Drops
Section 5 - Subscribers; Qualifications, Misrepresentation; Open Enrollment Periods
Section 5a - Discrimination Against Abuse Victims in Terms of Medical Service Plans
Section 5b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information
Section 6 - Subscription Certificate; Issuance; Content
Section 6a - Limited Extension of Benefits
Section 6b - Divorced or Separated Spouses; Continuation of Eligibility for Benefits
Section 7 - Contracts Between Corporation and Care Providers
Section 7a - Medicare Supplemental Group Coverage; Eligibility Due to Age or Disability
Section 7b - Medicare Supplemental Group Coverage; Medical Assistance Recipients
Section 7c - Retroactive Premium Rate Increase
Section 7d - Retroactive Claims Denial for Behavioral Health Services
Section 8 - Annual Statement; Verification, Form, Violations
Section 8a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset
Section 8b - Applicability of Chapter 176v to Medical Service Corporations Governed by This Chapter
Section 8c - Applicability of Chapter 176w to Medical Service Corporations Governed by This Chapter
Section 11 - Salaries, Compensation or Emoluments
Section 12 - Submission of Disputes or Controversies to Board; Privacy of Patient Information
Section 13 - Grounds for Enjoining Transaction of Business; Receivers
Section 14 - Liability of Corporation; Exemption From Insurance Laws; Tax Exemption
Section 16 - Operators of Medical Service Plan
Section 16a - Payroll Deductions of Governmental Employees
Section 18 - Contracts for Administrative or Other Services; Loans and Investments
Section 19 - Payment of Sums Owed Subscriber's Estate
Section 20 - Disclosure of Information; Mental or Nervous Condition
Section 21 - Insolvency of Health Maintenance Organization; Replacement Coverage
Section 22 - Statement Provided to Individuals Provided With Creditable Coverage; Report
Section 23 - Attribution of Members to a Primary Care Provider